中山地区高危型HPV基因分型特点及与阴道微生态功能、中医体质的相关性分析  

The Genotyping Characteristics of High-Risk HPV Types in Zhongshan and Their Correlation withVaginal Microecological Function and Traditional Chinese Medicine Constitution

作　　者：王山云 曾建峰[1] WANG Shanyun;ZENG Jianfeng(Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528400,China)

机构地区：[1]中山市中医院,广东中山528400

出　　处：《中国民族民间医药》2023年第22期112-118,共7页Chinese Journal of Ethnomedicine and Ethnopharmacy

基　　金：广东省中医药管理局立项课题:基于中医体质学的宫颈持续性高危型HPV感染危险因素分析及风险列线图构建和验证(20222253);中山市科技局立项课题:基于网络药理学对清毒洗液治疗宫颈持续性高危型HPV感染机制的实验研究(2022B1127)。

摘　　要：目的:为了解中山地区HPV基因分型感染情况及与阴道微生态功能学和中医体质的相关性;方法:对2022年1月至2022年7月在广州中医药大学附属中山医院行机会性宫颈筛查的女性11018例进行回顾性分析,探讨中山地区高危型HPV基因分型分别特点及与阴道微生态功能学、中医体质的相关性。对HPV检测同时行阴道微生态功能性检查并中医体质辨识的女性,随机选出HR-HPV阳性312例,以HR-HPV阴性313例作为对照组。通过阴道阴道微生态功能学测定分析两组阴道微生态功能学的特点,通过中医体质辨识分析了解两组中医体质分布特点。结果:高危型HPV总阳性率12.04%(1327/11018);30~39岁组的高危型HPV感染阳性率最高,感染率为11.23%,其次是40~49岁组,感染阳性率为11.0%;感染亚型统计分析发现单一分型中的其他12种分型感染率最高,阳性率为9.08%,其次是16型,阳性率为1.35%。HR-HPV感染组BV、乳酸杆菌、过氧化氢阳性占比均高于对照组,HR-HPV感染组葡萄糖苷酶阳性占比低于对照组,差异有统计学意义(P<0.05)。经Logistic多因素分析显示优势菌为乳酸杆菌的异常、BV、过氧化氢的检出率增高、葡萄糖苷酶均不是HR-HPV患者的阴道微生态异常的独立风险因素(P>0.005)。HR-HPV阳性组湿热质分布最多(21.43%),其次是痰湿质(19.39%)、气虚质(18.37%)。平和质、湿热质、痰湿质为HR-HPV感染的危险体质。湿热质对HR-HPV感染的影响最大(0R=2.199)。结论:中山地区高危型HPV总阳性率12.04%,以其他12种分型感染率最高,阳性率为9.08%,以30~39岁组的高危型HPV感染阳性率最高。中山地区高危型HPV基因分型与国内及广东省不同地区在感染率、感染年龄分布、感染型别等方面均有差异性。因此在宫颈癌防治及HPV疫苗研发中,需要结合当地情况开展工作。HR-HPV感染患者阴道微生态的BV、乳酸杆菌、过氧化氢阳性明显增高,葡萄糖苷酶阳性Objective To understand the situation of HPV genotype infection in Zhongshan area and its correlation with vaginal microecology and traditional Chinese medicine constitution.Method A retrospective analysis was conducted on 11018 women who underwent opportunistic cervical screening at Zhongshan Hospital affiliated to Guangzhou University of Traditional Chinese Medicine from January 2022 to July 2022.The characteristics of high-risk HPV genotypes in Zhongshan area and their correlation with vaginal microecology and traditional Chinese medicine constitution were explored.For women who underwent both HPV testing and vaginal microbiota functional testing,as well as traditional Chinese medicine constitution identification,312 cases with positive HR-HPV were randomly selected,and 313 cases with negative HR-HPV were used as the control group.Analyze the characteristics of two groups of vaginal microbiota through vaginal microbiota functional measurement,and understand the distribution characteristics of two groups of traditional Chinese medicine constitution through identification analysis of traditional Chinese medicine constitution.Result The total positive rate of high-risk HPV was 12.04%(1327/11018);The high-risk HPV infection positive rate is the highest in the 30-39 year old group,with an infection rate of 11.23%,followed by the 40-49 year old group,with an infection positive rate of 11.0%;Statistical analysis of infection subtypes found that the other 12 subtypes in a single subtype had the highest infection rate,with a positive rate of 9.08%,followed by 16 subtypes,with a positive rate of 1.35%.The proportion of BV,Lactobacillus,and hydrogen peroxide positivity in the HR-HPV infection group was higher than that in the control group,while the proportion of glucosidase positivity in the HR-HPV infection group was lower than that in the control group,with a statistically significant difference(P<0.05).Logistic multivariate analysis showed that the dominant bacteria were abnormal lactobacilli,increased detection rate

关 键 词：宫颈高危型HPV 基因分型 阴道微生态 中医体质 

分 类 号：R711[医药卫生—妇产科学]